{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T11:07:15Z","timestamp":1790161635281,"version":"4.1.0"},"reference-count":50,"publisher":"SAGE Publications","issue":"13","license":[{"start":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T00:00:00Z","timestamp":1787443200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to assess the relationship between the neutrophil-to-lymphocyte ratio (NLR) and systemic lupus erythematosus (SLE), with specific focus on the association between NLR and disease activity, including lupus nephritis (LN), and evaluating the correlation between NLR and the SLE Disease Activity Index (SLEDAI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of MEDLINE, Embase, and Web of Science from database inception through August 2025 was conducted. Meta-analyses compared NLR values between SLE patients and healthy controls, between active and inactive SLE, and between active LN and non-LN subgroups, with stratification by ethnicity, sample size, and publication year. Correlation coefficients between NLR and SLEDAI were pooled to assess the strength of this association.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-one studies comprising 4,006 SLE patients and 2,576 healthy controls were included. The combined analysis showed significantly increased NLR in SLE patients versus controls (SMD = 1.051, 95% CI = 0.817\u20131.286,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). Significantly higher NLR was observed in European, Asian, and Arab SLE patients relative to healthy controls within each respective subgroup, by showing significantly higher NLR in European (SMD = 1.058, 95% CI = 0.402\u20131.713,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.002), Asian (SMD = 1.058, 95% CI = 0.839\u20131.278,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), and Arab (SMD = 1.127, 95% CI = 0.707\u20131.547,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001) populations. Comparing disease activity, active SLE patients had notably higher NLR than those with inactive disease (SMD = 1.134, 95% CI = 0.252\u20132.017,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.012). However, the difference in NLR between active LN and non-LN groups was not statistically significant (SMD = 0.467, 95% CI = \u22120.045\u20130.979,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.074). NLR showed a significant positive correlation with SLEDAI (correlation coefficient = 0.354, 95% CI = 0.256\u20130.444,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). Subgroup analysis revealed significant correlations in Asian (correlation coefficient = 0.358, 95% CI = 0.246\u20130.461,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001) and Arab (correlation coefficient = 0.525, 95% CI = 0.382\u20130.644,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001) populations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This meta-analysis demonstrates that NLR is significantly increased in SLE patients compared to healthy controls, and that NLR is associated with greater disease activity, supported by its positive correlation with SLEDAI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/09612033261481122","type":"journal-article","created":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T06:52:11Z","timestamp":1787554331000},"page":"1415-1425","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of neutrophil-to-lymphocyte ratio with disease activity in systemic lupus erythematosus: A meta-analysis"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4213-1909","authenticated-orcid":false,"given":"Young Ho","family":"Lee","sequence":"first","affiliation":[{"name":"Korea University College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gwan Gyu","family":"Song","sequence":"additional","affiliation":[{"name":"Korea University College of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,23]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.4078\/jrd.2025.0053"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.4078\/jrd.2024.0051"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S452444"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1586\/14779072.2016.1154788"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.reuma.2018.07.008"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2016.04.006"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.649693"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/09612033241295865"},{"key":"e_1_3_5_10_2","first-page":"74","article-title":"Assessment of hematologic indices for diagnosis in juvenile systemic lupus erythematosus","volume":"62","author":"Baykal G\u00d6","year":"2024","unstructured":"Baykal G\u00d6, Vazge\u00e7er EO, S\u00f6zeri B. Assessment of hematologic indices for diagnosis in juvenile systemic lupus erythematosus. Reumatologia 2024; 62: 74.","journal-title":"Reumatologia"},{"key":"e_1_3_5_11_2","first-page":"115","volume-title":"A potential biomarker of disease activity in systemic lupus erythematosus, systemic immune-inflammation index","author":"Akdogan MR","year":"2024","unstructured":"Akdogan MR, Melikoglu MA. A potential biomarker of disease activity in systemic lupus erythematosus, systemic immune-inflammation index. Northern Clinics of Istanbul, 2024, vol 11, p. 115."},{"key":"e_1_3_5_12_2","first-page":"108","article-title":"Significance of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as prognostic markers of disease severity in systemic lupus erythematosus","author":"Babu N","year":"2024","unstructured":"Babu N, Nilofar F, Palanisamy S, et al. Significance of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio as prognostic markers of disease severity in systemic lupus erythematosus. Georgian Med News 2024: 108\u2013112.","journal-title":"Georgian Med News"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-024-07446-w"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-023-03704-z"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11102782"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/09612033231206446"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jri.2023.103978"},{"key":"e_1_3_5_18_2","first-page":"9406414","article-title":"Neutrophil-to-lymphocyte ratios and platelet-to-lymphocyte ratios in juvenile systemic lupus erythematosus: correlation with disease manifestations","volume":"10","author":"Li W","year":"2021","unstructured":"Li W, Liu S, Chen C, et al. Neutrophil-to-lymphocyte ratios and platelet-to-lymphocyte ratios in juvenile systemic lupus erythematosus: correlation with disease manifestations. Ann Palliat Med 2021; 10: 9406414\u20139409414. https:\/\/doi.org\/10.21037\/apm-21-1995","journal-title":"Ann Palliat Med"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/0961203320929753"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/labmed\/lmaa002"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.23230"},{"key":"e_1_3_5_22_2","first-page":"79","article-title":"Exploratory analysis of neutrophil lymphocyte rate and erythrocyte distribution width in the diagnosis of systemic lupus erythematosus","volume":"26","author":"Zhao YLZL","year":"2019","unstructured":"Zhao YLZL, Qian CR, Gong QH, et al. Exploratory analysis of neutrophil lymphocyte rate and erythrocyte distribution width in the diagnosis of systemic lupus erythematosus. Lab Immun Clin Med 2019; 26: 79\u201382.","journal-title":"Lab Immun Clin Med"},{"key":"e_1_3_5_23_2","first-page":"191","article-title":"The correlation analysis between the neutrophil-lymphocyte ratio and systemic lupus erythematosus viscera involvement and disease activity","volume":"35","author":"Lin W","year":"2019","unstructured":"Lin W, Zhang W, Li T, et al. The correlation analysis between the neutrophil-lymphocyte ratio and systemic lupus erythematosus viscera involvement and disease activity. Chinese J. Nephrol. 2019; 35: 191\u2013197.","journal-title":"Chinese J. Nephrol"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.22633"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/jcla.23211"},{"key":"e_1_3_5_26_2","first-page":"1547","article-title":"Predictive value of the neutrophil-to-lymphocyte ratio and hemoglobin insystemic lupus erythematosus","volume":"16","author":"Yu H","year":"2018","unstructured":"Yu H, Jiang L, Yao L, et al. Predictive value of the neutrophil-to-lymphocyte ratio and hemoglobin insystemic lupus erythematosus. Exp Ther Med 2018; 16: 1547\u20131553. https:\/\/doi.org\/10.3892\/etm.2018.6309","journal-title":"Exp Ther Med"},{"key":"e_1_3_5_27_2","first-page":"2428","article-title":"Correlation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, mean platelet volume with disease activity in systemic lupus erythematosus","volume":"47","author":"Qin F","year":"2018","unstructured":"Qin F, Wei W, Zou Y, et al. Correlation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, mean platelet volume with disease activity in systemic lupus erythematosus. Chongqing Medicine. 2018; 47: 2428\u20132431.","journal-title":"Chongqing Medicine"},{"key":"e_1_3_5_28_2","first-page":"2428","article-title":"Correlation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, mean platelet volume with disease activity in systemic lupus erythematosus","volume":"47","author":"Qin FXWW","year":"2018","unstructured":"Qin FXWW, Zou Y, Chen JF, et al. Correlation of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, mean platelet volume with disease activity in systemic lupus erythematosus. Chongqing Med 2018; 47: 2428\u20132431.","journal-title":"Chongqing Med"},{"key":"e_1_3_5_29_2","first-page":"490","article-title":"Application of NLR and NC3R in assessing disease activity of systemic lupus erythematosus","volume":"36","author":"Yu J","year":"2018","unstructured":"Yu J, Zeng T, Wu Y, et al. Application of NLR and NC3R in assessing disease activity of systemic lupus erythematosus. Chin J Clin Lab Sci. 2018; 36: 490\u2013492.","journal-title":"Chin J Clin Lab Sci"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.4103\/0366-6999.221272"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-017-3792-5"},{"key":"e_1_3_5_32_2","first-page":"2673","article-title":"The correlation of neutrophil to lymphocyte ratio and complement C3 with the disease activity of systemic lupus erythematosus","volume":"27","author":"Chen SYZZ","year":"2017","unstructured":"Chen SYZZ, Cl W, Ym S, et al. The correlation of neutrophil to lymphocyte ratio and complement C3 with the disease activity of systemic lupus erythematosus. Chin J Health Lab Technol 2017; 27: 2673\u20132676.","journal-title":"Chin J Health Lab Technol"},{"key":"e_1_3_5_33_2","first-page":"11026","article-title":"Neutrophil-lymphocyte ratio in systemic lupus erythematosus disease: a retrospective study","volume":"8","author":"Li L","year":"2015","unstructured":"Li L, Xia Y, Chen C, et al. Neutrophil-lymphocyte ratio in systemic lupus erythematosus disease: a retrospective study. Int J Clin Exp Med 2015; 8: 11026\u201311031.","journal-title":"Int J Clin Exp Med"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1159\/000447948"},{"key":"e_1_3_5_35_2","unstructured":"Liu XQ Duan YN Shi L et al. The application of red cell distribution width and neutrophil to lymphocyte ratio in systemic lupus erythematosus. China Mod. Doc 2016; 33: 22\u201324. 29."},{"key":"e_1_3_5_36_2","doi-asserted-by":"publisher","DOI":"10.3109\/14397595.2015.1091136"},{"key":"e_1_3_5_37_2","first-page":"170","article-title":"The role of neutrophyl lymphocyte count ratio as an inflammatory marker in systemic lupus erythematosus","volume":"45","author":"Oehadian ASH","year":"2013","unstructured":"Oehadian ASH, Dewi S, Pramudyo R, et al. The role of neutrophyl lymphocyte count ratio as an inflammatory marker in systemic lupus erythematosus. Acta Med Indones 2013; 45: 170\u2013174.","journal-title":"Acta Med Indones"},{"key":"e_1_3_5_38_2","doi-asserted-by":"publisher","DOI":"10.4078\/jrd.2023.0059"},{"key":"e_1_3_5_39_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-5-13"},{"key":"e_1_3_5_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2015.11.052"},{"key":"e_1_3_5_41_2","volume-title":"The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses","author":"Wells G","year":"2000","unstructured":"Wells G, Shea B, O\u2019connell D, et al. The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses, 2000."},{"key":"e_1_3_5_42_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_3_5_43_2","doi-asserted-by":"publisher","DOI":"10.4078\/jrd.2024.0095"},{"key":"e_1_3_5_44_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7121.1533"},{"key":"e_1_3_5_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/0197-2456(86)90046-2"},{"key":"e_1_3_5_46_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_3_5_47_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"e_1_3_5_48_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.0006-341X.2000.00455.x"},{"key":"e_1_3_5_49_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2017.00081"},{"key":"e_1_3_5_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2019.105949"},{"key":"e_1_3_5_51_2","doi-asserted-by":"publisher","DOI":"10.6061\/clinics\/2020\/e1450"}],"container-title":["Lupus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09612033261481122","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/09612033261481122","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/09612033261481122","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T10:16:22Z","timestamp":1790158582000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/09612033261481122"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,23]]},"references-count":50,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2026,11]]}},"alternative-id":["10.1177\/09612033261481122"],"URL":"https:\/\/doi.org\/10.1177\/09612033261481122","relation":{},"ISSN":["0961-2033","1477-0962"],"issn-type":[{"value":"0961-2033","type":"print"},{"value":"1477-0962","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,23]]}}}